Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study

Artemisinin-naphthoquine (ART-NQ) is a coformulated antimalarial therapy marketed as a single-dose treatment in Papua New Guinea and other tropical countries. To build on limited knowledge of the pharmacokinetic properties of the components, especially the tetra-aminoquinoline NQ, we studied ART-NQ...

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Main Authors: Batty, Kevin, Salman, Sam, Moore, Brioni, Benjamin, John, Lee, Sook Ting, Page-Sharp, Madhu, Pitus, Nolene, Ilett, Kenneth, Mueller, Ivo, Hombhanje, Francis, Siba, Peter, Davis, Timothy
Format: Journal Article
Published: American Society for Microbiology 2012
Online Access:http://hdl.handle.net/20.500.11937/36181
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author Batty, Kevin
Salman, Sam
Moore, Brioni
Benjamin, John
Lee, Sook Ting
Page-Sharp, Madhu
Pitus, Nolene
Ilett, Kenneth
Mueller, Ivo
Hombhanje, Francis
Siba, Peter
Davis, Timothy
author_facet Batty, Kevin
Salman, Sam
Moore, Brioni
Benjamin, John
Lee, Sook Ting
Page-Sharp, Madhu
Pitus, Nolene
Ilett, Kenneth
Mueller, Ivo
Hombhanje, Francis
Siba, Peter
Davis, Timothy
author_sort Batty, Kevin
building Curtin Institutional Repository
collection Online Access
description Artemisinin-naphthoquine (ART-NQ) is a coformulated antimalarial therapy marketed as a single-dose treatment in Papua New Guinea and other tropical countries. To build on limited knowledge of the pharmacokinetic properties of the components, especially the tetra-aminoquinoline NQ, we studied ART-NQ disposition in Papua New Guinea children aged 5 to 12 years with uncomplicated malaria, comparing a single dose (15 and 6 mg/kg of body weight) administered with water (group 1; n = 13), a single dose (22 and 9 mg/kg) with milk (group 2) (n = 17), and two daily doses of 22 and 9 mg/kg with water (group 3; n = 16). The plasma NQ concentration was assayed by high-performance liquid chromatography, and the plasma ART concentration was assayed using liquid chromatography-mass spectrometry. Population-based multicompartment pharmacokinetic models for NQ and ART were developed. NQ disposition was best characterized by a three-compartment model with a mean absorption half-life (t1/2) of 1.0 h and predicted median maximum plasma concentrations that ranged as high as 57 μg/liter after the second dose in group 3. The mean NQ elimination t1/2 was 22.8 days; clearance relative to bioavailability (CL/F) was 1.1 liters/h/kg; and volume at steady state relative to bioavailability (Vss/F) was 710 liters/kg. Administration of NQ with fat (8.5 g; 615 kJ) versus water was associated with 25% increased bioavailability. ART disposition was best characterized by a two-compartment model with a mean CL/F (4.1 liters/h/kg) and V/F (21 liters/kg) similar to those of previous studies. There was a 77% reduction in the bioavailability of the second ART dose (group 3). NQ has pharmacokinetic properties that confirm its potential as an artemisinin partner drug for treatment of uncomplicated pediatric malaria.
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institution Curtin University Malaysia
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last_indexed 2025-11-14T08:44:32Z
publishDate 2012
publisher American Society for Microbiology
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spelling curtin-20.500.11937-361812023-02-22T06:24:16Z Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study Batty, Kevin Salman, Sam Moore, Brioni Benjamin, John Lee, Sook Ting Page-Sharp, Madhu Pitus, Nolene Ilett, Kenneth Mueller, Ivo Hombhanje, Francis Siba, Peter Davis, Timothy Artemisinin-naphthoquine (ART-NQ) is a coformulated antimalarial therapy marketed as a single-dose treatment in Papua New Guinea and other tropical countries. To build on limited knowledge of the pharmacokinetic properties of the components, especially the tetra-aminoquinoline NQ, we studied ART-NQ disposition in Papua New Guinea children aged 5 to 12 years with uncomplicated malaria, comparing a single dose (15 and 6 mg/kg of body weight) administered with water (group 1; n = 13), a single dose (22 and 9 mg/kg) with milk (group 2) (n = 17), and two daily doses of 22 and 9 mg/kg with water (group 3; n = 16). The plasma NQ concentration was assayed by high-performance liquid chromatography, and the plasma ART concentration was assayed using liquid chromatography-mass spectrometry. Population-based multicompartment pharmacokinetic models for NQ and ART were developed. NQ disposition was best characterized by a three-compartment model with a mean absorption half-life (t1/2) of 1.0 h and predicted median maximum plasma concentrations that ranged as high as 57 μg/liter after the second dose in group 3. The mean NQ elimination t1/2 was 22.8 days; clearance relative to bioavailability (CL/F) was 1.1 liters/h/kg; and volume at steady state relative to bioavailability (Vss/F) was 710 liters/kg. Administration of NQ with fat (8.5 g; 615 kJ) versus water was associated with 25% increased bioavailability. ART disposition was best characterized by a two-compartment model with a mean CL/F (4.1 liters/h/kg) and V/F (21 liters/kg) similar to those of previous studies. There was a 77% reduction in the bioavailability of the second ART dose (group 3). NQ has pharmacokinetic properties that confirm its potential as an artemisinin partner drug for treatment of uncomplicated pediatric malaria. 2012 Journal Article http://hdl.handle.net/20.500.11937/36181 10.1128/AAC.06250-11 American Society for Microbiology unknown
spellingShingle Batty, Kevin
Salman, Sam
Moore, Brioni
Benjamin, John
Lee, Sook Ting
Page-Sharp, Madhu
Pitus, Nolene
Ilett, Kenneth
Mueller, Ivo
Hombhanje, Francis
Siba, Peter
Davis, Timothy
Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study
title Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study
title_full Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study
title_fullStr Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study
title_full_unstemmed Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study
title_short Artemisinin-Naphthoquine Combination Therapy for Uncomplicated Pediatric Malaria: a Pharmacokinetic Study
title_sort artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: a pharmacokinetic study
url http://hdl.handle.net/20.500.11937/36181